Looked After Children & Complex Needs

Placement Sufficiency Strategy

2019 – 2024

Keeping children and young people safe and giving them a great start in life

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Contents

1. Vision and Principles

2. Two Page Placement Sufficiency Strategy 2019-2024

3. Background to the Sufficiency Duty

4. Local Context

5. Commissioning Intentions 2019-2024

6. Placement Commissioning Plan 2019-2024

Appendix 1: Looked After Children & Complex Needs Placement Needs Analysis (October 2018)

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1. Vision and Principles

1.1 As a member of Herefordshire’s Children and Young People’s Partnership, the Council shares the vision to:

Keep children and young people safe and give them a great start in life

1.2 In achieving this vision, the partnership is committed to supporting the resilience of families

to prevent avoidable entry or repeat admission, into the looked after system. It endeavours to ensure there is a continuum of services to address the range of needs so that families are equipped to appropriately care for, and meet the needs of, their own children.

1.3 When a child comes into care, the council becomes their Corporate Parent. This means it is the collective responsibility of the council, elected members, employees, and partner agencies, to provide the best possible care and safeguarding for the children who are looked after by us. As corporate parents, we have the same goals for the children we look after as those of every good parent; to see our young people flourish, to enjoy good health, to be safe and happy, to do well at school and to grow towards adulthood equipped to lead independent lives and to make their way as happy, healthy, successful and financially secure adults.

1.4 When a child or young person does become looked after, the following local principles inform how their accommodation placements are commissioned, planned and delivered:

i. placements will be needs led and should enable looked after children to achieve positive outcomes as they grow-up

ii. most looked after children should achieve permanence, whether that be through reunification, special guardianship orders, or adoption

iii. children and young people are usually best placed in an appropriate and well-matched family environment, and the use of residential accommodation should be rare at less than ten placements

iv. looked after children and young people should normally be placed within 20-miles of their home in order to maintain contact with their family, education and community, unless it is not in their best interests to do so

v. placements will be stable, of good quality and cost effective

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2. Two Page Placement Sufficiency Strategy 2019-2024

What we know

LAC population has continued to grow, 326 at November 2018

Herefordshire could expect 180-220 LAC, compared to statistical neighbours

New entrants have recently slowed Ceasing LAC had not improved significantly

by 2017/18, particularly for special guardianship orders (SGO)

There are a wide range of needs Spending over £12.5m per year on

placements

What we are doing

2018/19 LAC reduction plan implemented to improve SGO rates, expecting to achieve c.310-330 LAC by April 2019

Sustained implementation of Early Help with partners

Embedding new Edge of Care approaches Improving social care practice, management and

leadership

Children and Young People

What we expect to achieve

LAC population will reduce to c.230-275 by 2024

General and Specialist Foster care

What we know

Placements provided by in-house carers and Independent Fostering Agencies (IFAs)

92% of in-house and 64% of IFA placements made within 20 miles of home in 2017/18

Usually 225-245 placements Annual spend c.£7m In-house foster care at £550 per

week is significantly cheaper than framework (£780) or spot-purchase (£920) IFA placements

In-house occupancy rates at 1.2 children per household (March 2018)

37 in-house kinship carers (March 2018)

107 general and specialist in-house carer households (November 2018)

In-house/IFA bed night split estimated at 63%/37% for 2018/19

Estimate c.70,000 nights needed in 2018/19

What we are doing

Maximising opportunities for kinship care to reduce demand on in-house general and specialist foster care

New in-house fostering marketing officer appointed in 2018 to drive carer recruitment efforts

Implementing a robust in-house foster carer recruitment, retention and training plan that is informed by an up-to-date needs analysis

Invest-to-save business case Developing better relationships with local IFAs for easier

access to local carers when necessary Participating in the recommissioning of regional agreements

for the purchase of IFA placements from April 2020

What we expect to achieve

90% of general and specialist fostered LAC being placed within 20 miles of home by 2024

90%/10% split of in-house/IFA fostering bed nights by 2024 Total of c61-71,000 bed nights provided in 2019/20, falling

to c50-60,000 by 2024 as LAC numbers reduce In-house capacity will improve to provide up to 170 beds /

53,000 nights per year by 2024 IFA nights to reduce to under 6,000 per year by 2024 No children will be placed in residential care because there

was no suitable fostering placement available

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What we know

No in-house residential children’s homes All placements are purchased from the

independent sector Includes mainstream LAC and children with

complex behaviours or disabilities 30% of LAC and 42% of complex needs

residential placements made within 20 miles of home, March 2018.

Annual spend c.£5.5m Usually 25-27 children placed More children have entered residential care

in 2018/19 because of insufficient capacity in the in-house and IFA markets

Estimate 5,700 LAC and 4,000 Complex Needs bed nights needed in 2018/19

Ofsted noted the strength of the commissioned Herefordshire Intensive Placement Support Service (HIPSS) which aims to prevent step-up to, and support step-down from, residential care

Children and young people can step-down to HIPSS, fostering, supported living or return home - 9 in 2016/17, 6 in 2017/18

What we are doing

Ensuring in-house recruitment targets specialist foster carers to reduce reliance on residential care

Strengthening strategic relationships with registered managers of local children’s homes to improve access to vacant beds

Developing additional relationships with new homes as they open in and around Herefordshire

Joining new regional agreement for the purchase of residential placements from January 2019

Consider short-term residential care as breathing space before a child returns home or to foster care

Making a decision, by Spring 2019, regarding potential for block contracting or in-house provision

Residential Care

What we expect to achieve

Less than 20 children and young people placed in residential care by 2024

A higher proportion will be placed within 20 miles of their home

Need for c.3,600 LAC and 3,700 Complex Needs bed nights per year by 2024

In-house fostering service will maintain a pool of 8-10 specialist carers to support HIPSS approach

What we know

Placements are provided by in-house ‘hosts’ and external agencies, Ofsted registration is not required

Provides support to achieve independence

Ofsted inspectors noted that care leavers live in good-quality placements and accommodation

At least 104 LAC will transfer into the 16+ service over 2019-2024

Estimated that c.30 LAC aged 16/17, and c.20 care leavers, will require supported living placements each year

Estimated that 6,000-6,500 bed nights provided in 2018/19

32 in-house supported lodging beds available in March 2018

What we are doing

In-house hosts to be integrated with recruitment and retention planning for foster care

Further refinement of needs analysis Joining recommissioned sub-regional supported

accommodation framework agreement Completing commissioning of floating support /

accommodation for young people with higher needs

16+ Supported Living

What we expect to achieve

Clearer projections of demand to inform evolving commissioning plan

Increase in-house supported lodgings places (excluding dual registrations) available for LAC and care leavers

High proportion of external agency placements are provided within 20 miles of the young person’s home, education, or employment

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3. Background to the Sufficiency Duty

3.1 The purpose of this document is to set out what Herefordshire Council will do to ensure that

there is sufficient accommodation of different types for our looked after children and young people (LAC). This sufficiency strategy has been informed by a needs analysis of the children and young people we look after (Appendix 1). The strategy is part of a whole-system approach that includes early intervention and preventive services to support children within their families, as well as better support services for children who become looked after.

3.2 Section 22G of the Children Act 1989 seeks to improve outcomes for looked after children and young people by requiring local authorities to take steps that secure, so far as reasonably practicable, sufficient accommodation within the authority’s area which meets the needs of children that the local authority are looking after, and whose circumstances are such that it would be consistent with their welfare for them to be provided with accommodation that is in the local authority’s area (‘the sufficiency duty’).

3.3 In complying with this duty, the Council seeks to do more than simply ensure that

accommodation is ‘sufficient’ in terms of the number of beds provided. We will have regard to the benefits of securing a range of accommodation through a number of providers to ensure the accommodation meets the child or young person’s needs. We recognise these needs can be wide-ranging and can require an holistic approach.

3.4 As a local authority, the Council is subject to a range of duties towards children within our area

which are related to the sufficiency duty. In particular: Section 17(1) of the 1989 Act provides that it is the general duty of a local authority to

provide a range and level of services to children in need (as defined in section 17(10) of the 1989 Act) and their families in the local area which are appropriate to their needs.

Section 20 of that Act requires local authorities to provide accommodation for children in need within their area who appear to them to require accommodation in accordance with the provisions of that section.

Section 21 requires a local authority to accommodate certain children who are either removed or kept away from home under Part V of the 1989 Act or who are subject to a criminal court order.

Section 22C (5) requires local authorities to place children in the most appropriate placement available. In determining the most appropriate placement for a child, section 22C (7) requires local authorities to take into account a number of factors (such as the duties to safeguard and promote welfare; promote educational achievement; ascertain the wishes of the child and family; and give due consideration to religious persuasion, racial origin and cultural background).

In determining the most appropriate placement for a child, section 22C(7)(a) also requires the local authority to give preference to a placement with a relative, friend or other person connected with the child and who is also a local authority foster parent.

Section 22C sets out the additional factors (in no order of priority) which the local authority must take into consideration when deciding the most appropriate placement:

allowing the child to live near his/her home; not disrupting the child’s education or training; enabling the child and a looked after sibling to live together; meeting the particular needs of disabled children; and providing accommodation within the local authority’s area, unless that is not

reasonably practicable. Section 23(1) (a) requires a local authority to provide accommodation for a child who is in

their care (by virtue of a care order).

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3.5 This strategy seeks to address the sufficiency, quality and sustainability of appropriate placement provision, as well as seeking value for money within the available resources. In this context, ‘commissioning’ represents the design and implementation of both in-house and externally provided services that are based on an analysis of local needs and evidence of what works well. The sufficiency strategy forms part of the Council’s overall approach to commissioning services for children, young people and families and represents a key priority area.

3.6 The types of placements that this strategy considers include: i. Fostering: kinship arrangements, general or specialist in-house foster carers and

independent fostering agencies (IFAs) ii. Independent residential children’s homes or schools for looked after children and those

with complex needs iii. In-house supported lodgings for 16+ looked after children and care leavers iv. Independent supported accommodation for 16+ looked after children and care leavers

4. Local Context

4.1 There are multiple factors that can influence the size and shape of Herefordshire’s LAC

population (below).

4.2 Compared to the average of its statistical neighbours (below), Herefordshire has had a higher number of looked after children than would be expected for its population of children and young people. At the end of November 2018, there were 326 Herefordshire children and young people looked after by the local authority.

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4.3 In 2018, the Local Authority’s children’s social care services were inspected by Ofsted and

judged overall as requiring improvement. The Council has implemented a range of action plans aimed at improving management and leadership to deliver consistently high quality social work practice so that children who need help and protection and those in or leaving care have good experiences and make positive progress. Among the planned wide-ranging improvements are evolving approaches to Early Help and Edge of Care. While these approaches are focussed on ensuring that children and young people receive the right support at the right time, they are also expected to have an impact on the size of Herefordshire’s LAC population in the short and medium term.

4.4 Herefordshire’s current Early Help model was implemented in 2016, with the number of families being supported growing since then. By November 2018, the number of completed Early Help Assessments had risen to over 900, with most cases being led by partner agencies. However, it has been recognised that the approach is not yet fully embedded and understood by all partners. Therefore, the Council is leading work with partners to develop and deliver a new Early Help strategy and rolling-out Early Help training to key frontline professionals. To further strengthen the Early Help Offer, the Council is expanding its dedicated team of family support workers and strengthening links with the MASH (Multi Agency Safeguarding Hub) with the recruitment of an Early Help Coordinator in MASH. Through these and future actions, it expected that there will be:

improved identification of families who require Early Help and will receive support at an earlier stage

improved signposting of Early Help resources for professionals and families

a more user friendly system for professionals and families so that they can help themselves

an increase in families who take up the offer of Early Help following no further action by social care

more partners supported to complete Early Help assessments

upskilling of partner agencies in the MASH and improved communication and knowledge about the Early Help

information immediately available for social care if cases step up

4.5 Weaknesses within the Councils’ children’s social care planning and decision-making

processes have been identified. These include delayed or missed opportunities to develop care plans during the PLO (Public Law Outline) process, as well as foster-to-adopt placements are not being considered early enough and in all relevant situations when planning permanency for children. To help address these issues, the Local Authority implemented a new Alternatives to Care panel decision-making process in September 2018, which built on earlier appropriately targeted work to begin reducing the size of the LAC population. It is expected that the new panel process will deliver:

clear expectations that result in sustainable change to enable children to safely

remain in the care of their parents

improved timescales for achieving permanency for children

reduced demand for foster placements

increased number of foster to adopt placements

4.6 In terms of placement sufficiency planning, the inspection noted a lack of effective strategic

direction and future needs were not articulated clearly. This was compounded by the current (2014-2019) commissioning strategy not being underpinned by a comprehensive

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assessment of future needs. Work to refresh the 2014-2019 strategy and needs analysis was underway at the time of the inspection and has now been completed with the strategy set out by this document and Appendix 1. It is recognised that the level and type of need within the population is subject to dynamic change, the strategic needs analysis, therefore will be routinely updated so that strategy and actions can be amended as appropriate.

4.7 Based on local intelligence and assumptions of the impact of Early Help and Edge of Care work, and combined with comparisons against Herefordshire’s statistical neighbours, it is anticipated (October 2018) that Herefordshire could have c.232-276 looked after children by 2024 (below). There are a wide range of influencing factors that could pose a risk to the assumptions and projections, however, if these approaches are successful, Herefordshire’s LAC population will be brought into closer alignment with comparative areas. Close alignment, however, could be expected to take several more years. This analysis will be regularly refreshed to ensure that it continues to reflect local intelligence and published data as it is routinely updated.

5. Commissioning Intentions 2019-2024

5.1 A strategic placement sufficiency needs analysis (Appendix 1) has considered the historic and projected demand for placements. Key sufficiency pressures that have been identified are:

i. growing use and higher cost of independent fostering agency placements

ii. increased use of residential accommodation due to insufficient capacity in both general and specialist in-house and independent fostering provision

iii. too many children and young people placed away from home/Herefordshire when their needs do not require distant accommodation

iv. insufficient local provision of supported living arrangements for young people with higher needs

v. robust commissioning of non-accommodation support services for children in need (CIN), children subject to child protection (CP), looked after children (LAC) and those with complex needs (CNF)

5.2 To help address these pressures, the Council is working to achieve the following commissioning objectives:

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Commissioning objectives

1 Achieve a rate of 90% of general and specialist fostered LAC being placed within 20 miles of home and reduce reliance on independent fostering agencies

2 Ensure that more children needing residential care can be placed ideally in-county, but no more than ten miles from the Herefordshire border , when it is appropriate to their care plan

3 Improve the availability of local supported living arrangements for Looked After Children aged 16+

4 Implement robust procurement arrangements for non-accommodation support services for CIN, CP, LAC and CNF

5.3 The following commissioning plan sets out in more detail how these intentions will be achieved and measured.

6. Placement Commissioning Plan 2019-2024

Objective Actions Performance Measures

1. Achieve a rate of 90% of fostered LAC being placed within 20 miles of home and reduce reliance on IFAs

2018 Baselines: 2018 In-house/IFA bed

night split of 63%/37%

As of 31 March 2018, 84% of general in-house and IFA foster care was placed within 20 miles of home.

92% of children in general in-house foster care placements are placed within 20 miles of their home.

64% of IFA placements are within 20 miles of child’s home.

In-house occupancy rates at 1.2 children per household (March 2018) and good placement stability

37 in-house kinship carers (March 2018)

a. Maintain a robust in-house foster carer recruitment, retention and training plan that will increase the capacity of kinship, general and specialist foster carers so that: i. no children enter residential care when

foster care is suitable to meet their needs ii. in-house foster carers increase their

capabilities to support children more challenging needs, such as child sexual exploitation (CSE) etc

iii. reliance on IFA placements is reduced iv. fostering costs are sustainable

90% / 10% balance of in-house/ IFA fostering bed nights achieved by 2024 or sooner

monitor in-house occupancy rates against other areas in-house provision of at least 45,000, and up to 53,500

bed nights per annum by 2024 an in-house carer pool to provide up to 170 beds by

2024 carer pool includes at least 8 specialist Herefordshire

Intensive Placement Support Service (HIPSS) approved carers in August 2019

maintain a pool of 8-10 specialist HIPSS carers from September 2019

zero residential bed nights purchased due to no available foster care

b. Maximise opportunities for kinship care by implementing processes to identify potential kinship carers at earlier stages throughout the safeguarding child protection processes and not only at point of accommodation

Initial minimum of 20 kinship carers approved each year Further analysis of the potential scope for the use of

additional kinship care

c. Monitor in-house carer capacity against projected need within the directorate’s performance score card

Demand and capacity is routinely overseen by the directorate’s Senior Management Team (SMT)

d. Develop effective relationships with IFAs that have carers based in Herefordshire to ensure that agencies are aware of our needs and that we acquire regular updates on current and planned vacancies, so these could be considered for our young people, where applicable.

facilitate at least one provider market development event each year

at least 4 weekly contact with each local provider placements team receives regular vacancy updates from

IFAs working in Herefordshire

e. Participate in the recommissioning of West Midlands Regional Foster Care Framework arrangements

Local and regional decision, by September 2019, to recommission a new framework from April 2020

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Objective Actions Performance Measures

107 general and specialist in-house carers (November 2018)

2. Ensure that more children who need residential care can be placed ideally in-county, but no more than ten miles from the Herefordshire border , when it is appropriate to their care plan

2018 Baseline: As of March 2018, 30% of LAC residential placements were within 20 miles of the child’s home 42% of CNF placements were within 20 miles of child’s home

a. Strengthen strategic relationships with registered managers of local children’s homes in Herefordshire to ensure that they are aware of our needs for general LAC and Complex Needs accommodation and that we acquire regular updates on current and planned vacancies, so these could be considered for our young people

b. Develop similar strategic relationships with residential children’s homes and residential schools that could support children with complex needs in neighbouring counties

c. Work with the Local Authority Designated Officer (LADO) to explore re-instating children’s homes managers’ forums

facilitate at least one provider market development event each year

at least 4 weekly contact with each local children’s home placements team receives regular vacancy updates from

children’s homes in Herefordshire A minimum of 60% of all residential bed nights

purchased are in-county or within 10 miles of Herefordshire’s border, by 2022. Based on the active placements as of March 2018, 22% of LAC residential and 33% of CNF bed nights purchased were in county.

d. Make a decision about joining the new regional residential flexible contracting arrangements for 2019 onwards

Participate in design of new service specification and contracting arrangements by September 2018

Complete regional procurement exercise by November 2018

Make local governance recommendations and decision by December 2018

First new placements made under new arrangements from January 2019

e. Consider the potential for short-term ‘breather’ residential placements as an aide to preventing family breakdown or the breakdown of fostering placements

Exploration of models and evidence from elsewhere If a model appears feasible, include in business cases

described by actions f and g below

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Objective Actions Performance Measures

f. Make a decision about potentially undertaking a mini-procurement exercise to block contract an initial number of residential beds (likely to be four with an option to increase later) in a home or homes in Herefordshire. The procurement could be completed via the regional FCA or directly by Herefordshire.

Draft business case completed by February 2019 Governance completed by April 2019 Procurement completed by June 2019 Block-contract awarded from September 2019

g. Subject to the outcome of the procurement of block contract arrangements for residential beds, we will complete a business case for the development of a dedicated LAC and/or CNF children’s home resource in Herefordshire, which could be delivered under contract by an external provider or managed in-house by the Council

if needed, a draft business case will be prepared by October 2019

3. Improve the availability of local supported living arrangements for Looked After Children aged 16+

2018 Baseline: 32 in-house supported lodgings beds available

a. the in-house foster carer recruitment, retention and training plan will also address the capacity of in-house supported lodging hosts for 16-17 year olds, as well as care leavers, and identify why hosts tend to support only one young person at a time

Up to 40 supported lodging beds (excluding dual registrations) available by March 2020

b. Complete detailed analysis of future demand to better inform supported living sufficiency planning

Project demand by September 2019, based on known LAC that could step down to supported lodgings at age 16, 17 or 18

c. Continue to participate in sub-regional or regional supported accommodation framework agreements

Decision regarding renewal/ recommissioning by January 2019

d. Make a decision, in conjunction with the Adult and Communities Directorate, about commissioning an external provider to provide either floating support or supported accommodation for young people with higher levels of need

Decision made by May 2019

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Objective Actions Performance Measures

4. Implement robust procurement arrangements for non-accommodation support services for CIN, CP, LAC and CNF

2018 Baseline: Since 2015 to March 2018, in the region of 320 individual assessments have been commissioned at a total cost of approx. £245k

a. Make a decision about joining a sub-regional direct purchasing system (DPS) for non-accommodation services

Decision made by February 2019 DPS implemented from April 2019

b. Complete a needs analysis of non-accommodation services required by Herefordshire, identify any market gaps and actions to address

Needs analysis and action plan completed by May 2019

Looked After Children & Complex Needs

Placement Needs Analysis

October 2018

Keeping children and young people safe and giving them a great start in life

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Contents

1 Commissioning Principles

2 Needs Analysis Summary

3 LAC population planning assumptions 2019-2024

4 Placements Overview

5 Fostering Placements

5.4 In-house foster carers

5.27 Independent foster agency care (IFA)

6 LAC Residential placements

7 The Complex Needs Population

8 16+ LAC Population

9 Non-accommodation Services

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Commissioning Principles

1.1 In meeting the needs of the looked after child (LAC) and complex needs funding (CNF)

population, the following principles will drive Herefordshire’s sufficiency planning:

i. placements will be needs led and should enable looked after children to achieve positive outcomes as they grow-up

ii. most looked after children should achieve permanence, whether that be through reunification, special guardianship orders, or adoption

iii. children and young people are usually best placed in an appropriate and well-matched family environment, and the use of residential accommodation should be rare at less than ten placements

iv. looked after children and young people should normally be placed within 20-miles of their home in order to maintain contact with their family, education and community, unless it is not in their best interests to do so

v. placements will be stable, of good quality and cost effective

Needs Analysis Summary

2.1 The analysis of the LAC & CNF populations, service capacity and capabilities has shown that there are capacity pressures in Herefordshire’s provision of:

i. growing use and higher cost of independent fostering agency placements

ii. increased use of residential accommodation due to insufficient capacity in both general and specialist in-house and independent fostering provision

iii. too many children and young people placed away from home/Herefordshire when their needs do not require distant accommodation

iv. insufficient local provision of supported living arrangements for young people with higher needs

v. robust commissioning of non-accommodation support services for children in need (CIN), children subject to child protection (CP), looked after children (LAC) and those with complex needs (CNF)

LAC population planning assumptions 2019-2024 3.1 Why is population planning important?

Tests and informs organisational assumptions and expectations by being based on what can realistically be achieved, rather than what is desired

Considers potential impact of acting/not acting

Are we doing enough of the right things and fast enough?

Informs commissioning, operational delivery & workforce planning

Helps drive change and improvement

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Helps to monitor the direction of travel

3.2 There continues to be a significant difference between the size of Herefordshire’s LAC population and the average of statistical neighbours. Based on the last published national LAC data (November 2018, below), Herefordshire could expect to have 160 – 200 LAC. For planning purposes, it has been assumed that a population of 180 – 220 would bring Herefordshire closer to its statistical neighbours.

3.3 To bring Herefordshire’s LAC population closer to the size of its statistical neighbours by March 2024, it is estimated that an annual average reduction of 9% would be needed to achieve a population of 180, or 6.5% to achieve a population of 220.

3.4 There are multiple factors that can influence the size and shape of Herefordshire’s LAC population (below). The approach to Early Help and edge of care continues to develop locally, with the intention of preventing a child’s needs escalating and therefore slowing the rate of new entrants to the LAC system.

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3.5 The Council, working with its partners, is able to determine the effectiveness of the Early Help and edge of care responses. There are other external factors that are beyond the control of the Council and its partners that can influence LAC numbers, such as changes to legislation, regulation or government policy, or the potential fall-out from a safeguarding scandal in another area. Some children will need to remain looked after until their 18th birthday. However, once a child does become looked after, an improving social care response will mean that more children are able to successfully exit the LAC population through reunification with their family, special guardianship orders (SGO) or adoptions.

Looking back

3.6 Herefordshire’s annual rate of the population that cease LAC declined to less than 30% in 2016-2017, with a slight increase during 2017-18 to 32%, compared to a cessation rate of over 40% among statistical neighbours. Herefordshire’s cessation rate has been lower than its statistical neighbours since 2014:

3.7 Children ceasing to be LAC as a result of SGOs has been low, and is now being improved. The combined ‘business as usual’ rate of cessations as a result of reunification or SGO has been 7% of the LAC population, which is expected to gradually increase in future as a result of the action being taken to pursue SGO arrangements when appropriate.

3.8 Outside of children ageing out, or moving to SGO or reunification, a further 13% of the population cease to be LAC each year for a variety of other reasons. This rate of cessation can be expected to continue for the foreseeable future.

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3.9 In 2017/18, Herefordshire’s new entrant rate rose to 31 per 10,000 0-17 year olds compared to 2016/17 statistical neighbour rate of 22 (below). The statistical neighbour rate will be updated with the release of new national data, although the neighbour rate is expected to increase it is not expected to rise to near Herefordshire levels. Based on the available data, Herefordshire could expect to receive c.80 children per year into the care system if it were in line with statistical neighbours.

3.10 On average, Herefordshire has had 117 entrants to the looked after system each year since 2015 (below). 18% of new entrants were aged 16/17, which is anticipated to reduce below 15% as a result of improving edge of care arrangements.

3.11 By the end of September 2018, there had already been 54 new entries since April, which is a similar position to the same point in the previous year. It can therefore be expected that there will be a further c.45-50 entries by the end of March 2019, although this figure could reduce as a result of improvements already being made in edge of care support.

3.12 During 2018/19, the council implemented a LAC reduction plan to focus on a cohort of LAC, that had built-up over several years and who could achieve permanence through SGO or reunification within the year. The plan highlighted that up to 80 LAC could be supported in this way. At the time that the plan was initiated, there were approximately 313 looked after children, however, the number has increased to 333 by September 2018. As at September 2018, it is expected that between 26 and 41 LAC could move to reunification or SGOs by March 2019.

Looking forward

3.13 Based on previous trends, comparison with statistical neighbours and the expected impact of operational actions being taken to manage the LAC population, the LAC planning assumptions for 2019-2024 are:

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Estimated Population by April 2019

i. of the 333 children and young people already known to be in the LAC system at September 2018, there are 17 who will cease to be LAC by April 2019 as a result of reaching their 18th birthday

ii. targeted LAC reduction plans in 2018-2019 expect that 15-30 additional children will move to SGO or reunification by April 2019

iii. based on historic trends, a further 22 can expect to cease being LAC for ‘other reasons’, including adoption, custody etc.

iv. based on historic trends, a further 45-50 children can be expected to become LAC between 1 October 2018 and 31 March 2019

v. therefore a LAC population in the range of 309-329 LAC can be expected in April 2019

Estimated Population April 2019 – March 2024

i. A further 118 existing children and young people will cease to be LAC by the end of March 2024 as they become 18 years old. Some possibly sooner as a result of achieving permanency through ongoing LAC reduction planning

ii. LAC ceasing each year for ‘other reasons’ (including adoption, custody etc. but excluding ageing out, SGO, reunification) continues at 13% of the LAC population

Then either/or:

iii. Cautious assumptions: lighter change over longer time

Lower initial success of targeted LAC reduction/SGO work, followed further light success for two years

Continued 7% of population ceasing through reunification and SGO, based on historic trends

Overall cessations reach c.30% of LAC by 2024

Annual new entrant rate achieves parity with stat neighbours (c.80 CYP) by 2022

15% of new entrants are aged 16/17 at the time of entry and cease to be LAC within 2 years

iii. Optimistic assumptions: deeper change sooner

Higher initial success of targeted LAC reduction/SGO work, followed further good success for two years as business as usual is consistently improved

8% of population ceasing through reunification and SGO in 2019/20, rising to 10% by 2024,

Overall cessations reach c.37% of LAC by 2024, much closer to statistical neighbour rate of 40%

Annual new entrant rate achieved parity with stat neighbours (c.80 CYP) by 2020

15% of new entrants are aged 16/17 at the time of entry and cease to be LAC within 1 year

3.14 Based on these assumptions, the LAC population in 2024 would be c.232-276:

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3.15 Risks to the size of the LAC population

the planning assumptions could become seen as targets that have an unintended influence of decision-making for individual children

demand to take additional UASC is unclear a national safeguarding scandal could dramatically influence the rate of new LAC changes in legislation, regulation or national policy could also influence the size of the

LAC population

3.16 Herefordshire has a relatively small, but growing Black, Asian and Minority Ethnic (BAME) population; 6.4 per cent compared with 19.5 per cent nationally (census 2011). As of May 2018, the majority (97% of recorded) of LAC are either White British or any other white background. As the table below shows, there has been an increase in the LAC population of minority ethnic groups; partly due Herefordshire being part of Government’s national transfer scheme, where the Council has agreed to accept responsibility for up to 25 unaccompanied asylum seeking children (UASCs).

3.17 As of March 2018, Herefordshire was supporting 10 UASCs, 8 through the scheme and 2 who arrived independently. It is recommended the recruitment and retention plan also targets potential foster carers from Black, Asian and Minority Ethnic (BAME) group.

3.18 Comparing the LAC population by age and gender as of March 2014, to March 2018, shows an increase in all age ranges, with the exception of 0-4, which reduced from 64 to 54. With age ranges 4- 10 and 11-15 increasing by 45 and 38 young people respectively. In regards to gender, the male female split in 2018 was 50/50, compared to 52%/ 48% female to male split in 2014. However there is an increase in males in the 5-10 and 16+ age ranges, with more females aged 11 -15 age range.

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3.19 Children and young people will have differing needs which will result in having to enter the looked after system. Abuse or neglect has consistently been the predominant reason, accounting for 71% in 2017/18. However it is important to recognise it could be due to a combination of the different reasons. The reason recorded against UASC is absent parenting, which is anticipated to increase as Herefordshire has agreed to be part of Government’s national transfer scheme

3.20 There continues to be various reasons why children and young people cease being LAC. Since 2016, turning 18 and therefore aging out of the system is the predominant reason, with adoption being the main reason for under 5 year olds. A key indicator for the adoption service is the average time between a local authority receiving court authority to place a child and the local authority deciding on a match to an adoptive family. Herefordshire’s three year average was 251 days which is 130 days above the target of 120 days and compares with a national average of 226 days. This figure has been affected by success in placing older children for adoption.

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Placements Overview 4.1 The types of placement covered by the sufficiency strategy are provided either by the in-house

fostering service or and external independent agencies, including:

i. Fostering: kinship arrangements, general or specialist in-house foster carers and independent fostering agencies (IFAs)

ii. Independent residential children’s homes or schools for looked after children and those with complex needs. The Council does not operate any in-house residential provision.

iii. In-house supported lodgings for 16+ looked after children and care leavers iv. Independent supported accommodation for 16+ looked after children

4.2 Some LAC will be placed into other arrangements that are not a part of the sufficiency strategy

including pre-adoption, placements with parents, and kinship placements.

4.3 Since 2014, there has been a slight increase (5% to 6%) in the number of children and young people who have had 3 or more placement moves during a 12 month period. This is significantly less than the average for both statistical neighbours (12%) and nationally (10%). In contrast, Herefordshire has more children and young people who have in been placement for at least 2 years, 75% compared to 70% nationally. This could be partly attributed not identifying opportunities for them to return home, wherever possible or alternative permanency options being identified.

4.4 Statutory guidance makes it clear that children should live in the local authority area, with

access to local services and close to their friends and family, when it is safe to do so. The guidance emphasises that ‘having the right placement in the right place, at the right time’, with the necessary support services such as education and health in place, is crucial in improving placement stability, which leads to better outcomes for looked after children. Herefordshire strives to place it’s looked after children within 20 miles from their home wherever appropriate, and has made good improvements in reducing the number of children placed outside Herefordshire since 2015 (below).

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4.5 However, while almost 90% of all LAC were placed within 20 miles from home in March 2018, the rate falls to 84% for those that were placed in general in-house fostering or with independent agencies.

4.6 Out of county placement data, rather than distance from home data has been analysed in previous years. Since 2014, there has been a slight reduction in the number of agency placements (IFA, residential & CNF) being made out county. However there has been a slight reduction in proportion of supported accommodation placements made in-county; this is against an increase in placement numbers. Further sufficiency and performance management work will enable trends to be presented on a distance from home basis.

4.7 In March 2018, 90% of general in-house foster care placements were within Herefordshire; compared to 82%in 2016. For some children being a significant distance from Herefordshire is a positive outcome, if it means they are placed with family and friends.

4.8 Comparing the types of placements made in January 2014 to January 2018 (below), shows there that in-house fostering placements have increased by 21% and IFA placements increased by 30%. There has been a recent sharp increase in the use of IFA placements, which has mainly been due to insufficient capacity of in-house fostering.

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4.9 Whilst LAC residential has remained the same at 10 placements, this has varied throughout the year. There has been a 30% reduction in CNF placements and although the future trend is not clear, some increase may be anticipated as a result of children living longer with complex disabilities and health needs. Most residential and CNF placements are made out of county.

4.10 Whilst there has been a 160% (8 to 21) increase in supported accommodation, use and availability of this provision for 16+ has been promoted since 2013.

4.11 Spend (chart below) on LAC residential placements has increased each year since 2014/15. This is mainly attributed to:

needing to make residential placements when no fostering placements are identified for children who could be fostered and

not having sufficient specialist carers to enable the Herefordshire Intensive Placement Support Service (HIPSS) to support step down, or preventing step up to residential.

4.12 Spend on complex needs packages has reduced, which reflects decline in demand. However due to relatively small number of in this cohort, even a small change in the CNF population can have a significant impact on costs.

4.13 Spend on IFA placements continues to increase each year; this reflects increased demand, which is attributed to the rise in the LAC population and insufficient in-house capacity. To date IFA spend also includes supported accommodation provision. From March 2018, they are being costed against separate budgets enabling more accurate financial analysis.

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4.14 The overall spend on in-house fostering has increased by £1.9m since 2014 and will continue

to rise as capacity increases to enable more children to be placed with in-house carers. A cost analysis exercise has been undertaken based on April 2018 data to calculate a unit cost of a ‘general’ in-house foster care placement. The exercise considered all front and back office costs on a like-for-like basis in order to draw comparisons with the IFA market. The in-house fostering service continues to provide best value, with the average weekly cost for general foster care placement is £550, compared to £780 for placements made via the West Midlands Regional Foster Care Framework agreement and £920 for placements on spot purchase agreements.

Fostering Placements

5.1 Foster care provision includes:

General foster care – child has no pre-existing connection with carer. Foster carers can be registered with, and supported by their local authority (in-house) or independent foster agency (IFA)

Specialist foster carers - full time carers recruited by Herefordshire’s fostering service specifically to support Herefordshire intensive Placement Support Service (HIPSS)

Kinship foster care - in-house carer who is a relative, friend or relevant other with a pre-existing connection to child.

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5.2 During 2017/18, approximately 85% of the Herefordshire’s LAC population were in some form of foster care placement, with 72% requiring general foster care, which excludes kinship placements. This resulted in over 59,000 general foster care bed nights being provided, c.40,000 delivered by the in-house service and 19,500 purchased from the IFA sector.

5.3 Assuming that at least 72% of the LAC population continue to require general foster care, it is estimated that c70,000 general foster care bed nights will be provided in 2018/19 by the in-house service and IFAs. As the size of the LAC population is expected to reduce, the number of bed nights required will also decline with 50-60,000 being required by 2024.

Herefordshire Council’s in-house foster carers

In-house value

5.4 It is recognised there will be a need to place some children with agency foster carers, however preference should be to place with in-house carers wherever possible, which has the benefits of in-county carers, easy liaison between social care and other teams, and sustainable costs.

5.5 As the majority of general in-house foster carers live within Herefordshire, this helps to keep children close to their home and school, and maintain contact with the family and local community. Being placed in-county or a neighbouring county also supports social care to ensure robust assessments are in place to fully identify how to meet the child’s needs holistically and enable children to influence service planning in meaningful ways.

5.6 In-house foster care continues to provide best value. The Councils finance team undertook a bench-marking exercise in early 2018, comparing the costs of the in-house service to those of IFAs. The average weekly price for a general in-house foster carer is £550, compared £780 for placements made via the West Midlands Regional Foster Care Framework agreement and £920 for placements on a spot purchase agreements.

5.7 Whilst sufficiency planning focusses on in-house general foster carers, the role of kinship care is important as it releases in-house general foster carer capacity. In 2017/18 kinship carers provided 9100 bed nights.

In-house nights

5.8 The 2014-19 sufficiency strategy had the aim of achieving 90%/ 10% split for in-house/IFA bed nights by 2019 from a baseline of 68%/32%. In 2017/18 the split had deteriorated to 67%/33%. It is anticipated that the local position will worsen further by the end of 2018-19, with a split of 63%/37% being expected. This is a result of increasing LAC numbers and a slow growth rate in in-house carer capacity.

5.9 While the total foster bed nights is expected to decline as a result of a reducing LAC population by 2024, achieving the targeted 90% in-house to 10% agency split will mean

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increasing the number of bed nights provided by the in-house service from c.42,000 in 2019-20 to up to c.53,000 in 2024.

5.10 However, because of the projected population profile and starting position of the in-house/IFA split, the trajectory to c.53,000 nights in 2024 will not be a smooth one (see 5.17 Fostering Capacity Table). As the annual population projections are within a range, so too are the projected number of in-house bed nights within a lower and upper range. While realising the lower end of the annual bed night range will be a significant achievement, it should be seen as minimum provision, rather than a target to be attained. Exceeding the minimum provision will help the Council to more quickly achieve the intention of placing children closer to home and ensure costs are sustainable.

5.11 As of 31 March 2018, there were 135 children placed with general in-house foster carers of which 72 (53%) have been in placement for more than 12 months.

5.12 Of the children in general foster care placements during the year, the majority are aged 5 to 15 years. Whilst the number of 5 – 10 year olds has remained fairly stable at around 30%, there has been a slight annual reduction in 11 to 15 year olds, from 40% in 2015/16 to 35% last year. Annually there have been more 0 – 4 year olds placed, which is not unexpected given it is understood carers tend to have preference for this age range.

In-house carer pool

5.13 As of November 2018, there were 107 approved general in-house foster carer households, including HIPSS. Compared to other areas, the in-house service has performed relatively well in recruiting new carers. Since 2014, a net increase of 15 general in-house foster carers has been achieved, however the 2014-2019 sufficiency strategy target of 21-30 additional carers by 2019 is not expected to be achieved. The slower than expected rate of improvement may be partly attributed to the fostering service not having a robust recruitment and retention plan informed by projected sufficiency requirements.

5.14 Whilst carers have been recruited, others have resigned. In 2017/18 there was an increase in the number of resignations with 17 general foster carers resigning, compared to 12 during 2016/17. There have been various reasons for resignation including carers transferring to an IFA, age retirement and changes to personal circumstances. As of May 2018, the in-house cohort of main carers were 91% female. Their ages range from 30 to 77, with the average being 54 years. Of this, 16 are aged 65 and over, 11 are aged 70 and over. It can be anticipated that a significant proportion of the current carer pool may retire within the next couple of years.

5.15 It is accepted that most children are best placed with other children in a supportive family environment. However, of the 107 general in-house fostering households (inc. HIPSS) in November 2018, most 42% (45) were supporting only one child, with 20% supporting two children, and 13% supporting 3 or more children. Furthermore, 26% of

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households had no active placements; although some of these may be a result of recent place moves and preparations being made for planned introductions.

5.16 Carer households will be registered to provide accommodation for a specified number of children, often up to three, although the number of children usually placed with a carer is frequently less than their registration number. In March 2018, there were 119 general foster carers, 31 of which had no child in placement, suggesting a vacancy rate of 26%. At that time however, Herefordshire’s in-house carer households were registered, on average, to accommodate 2.3 children each, but the average number of placements being provided was 1.2 children per carer household, suggesting an occupancy rate of around 50%. Whilst this rate may appear low, it is likely to be a reflection of good levels stability among in-house placements

5.17 The fostering capacity table below shows the estimated number of fostering nights required each year, based on projected changes in the LAC population and the desired move to a 90/10 in-house/IFA split. For example, it is estimated that c.45-51,500 in-house nights will be required in 2019/20 equating to 143 to 164 beds, including a nationally benchmarked 16% vacancy rate.

Fostering Capacity Table

5.18 Assuming that the in-house service maintains an average occupancy rate of 1.2 children per carer household, the service will need to increase to a pool of 119-137 households in 2019-2020, and a similar level for 2023-24. This will mean an increase from the latest position of 107 carer households (November 2018). However, assuming that the occupancy rate could be improved, for example increasing to the average registration rate of 2.3 children per household, c.60-75 households would be sufficient each year 2019-2024, which is fewer carers than are currently available and could reduce back-office pressure in terms of carer recruitment, training and supervision.

5.19 Further work will be completed to break down the number of nights and carer household needed each year to consider gender, age groups and solo/shared placement requirements.

5.20 Based on this assessment, and the intention to provide sufficient general in-house carer households, the key areas of focus for the in-house recruitment and retention plan should include:

i. Monitor occupancy rates against other areas

ii. Maximising opportunities kinship

iii. approving additional carer households, in particular those that can support older children and/or multiple placements

Lower

Estimate

Upper

Estimate

Lower

Estimate

Upper

Estimate

Lower

Estimate

Upper

Estimate

Lower

Estimate

Upper

Estimate

Lower

Estimate

Upper

Estimate

286 329 254 310 243 296 236 283 232 276

# LAC fostered (c.72%) 206 237 183 223 175 213 170 204 167 199

61423 70658 54551 66578 52188 63571 50685 60779 49826 59275

32% 32% 26% 26% 21% 21% 15% 15% 10% 10%

19410 22328 14292 17443 10855 13223 7805 9360 4983 5928

68% 68% 74% 74% 79% 79% 85% 85% 90% 90%

42013 48330 40258 49134 41333 50348 42879 51419 44843 53348

# general foster beds 115 132 110 135 113 138 117 141 123 146

134 154 128 156 131 160 136 163 143 170

111 128 107 130 109 133 114 136 119 141

2019-20 2020-21 2021-22 2022-23 2023-24

LAC population

Fostering nights required

Target IFA proportion

IFA nights

Target in-house proportion

# In-house nights

# carers based on avg 1.2

placements per household

# general beds with

16% vacancy

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5.21 Since September 2014, HIPSS has provided wrap-around intensive therapeutic support packages around the child or young person and their carers targeted by the service, to step-down from or at risk of requiring residential care. The service has capacity to support 8-10 specialist carers, with the foster care service having responsibility for recruiting and supervising the carers. With the exception of a few months, the HIPSS service has been operating below capacity; although they continue to support non-specialist carers.

5.22 Although 2 new HIPSS carers were approved in early 2018 increasing the number of carers to 7, this reduced back down to 5 by August 2018 following resignations. A focused recruitment programme is required with the target of recruiting 2 full time approved HIPSS carers by August 2019 and a further 2 by March 2020. This will need to be revised in line with resignations to ensure a minimum cohort of 8 is maintained.

Independent foster agency care (IFA)

5.23 Priority is to place with in-house carers wherever possible. However due to no in-house

options being available for some children, the number of IFA bed-nights purchased per year has grown by more than 10,000 during the period 1 April 2014 to 31 March 2018.

5.24 Many local authorities are experiencing challenges making IFA placements due to insufficient supply to meet demand within the sector. In some cases, this has led to children entering residential accommodation when a fostering placement would be appropriate to their needs.

5.25 Local data shows there are 2 registered foster care agencies with head offices in Herefordshire and a further 11 fostering agencies with carers within the county. As of September 2018, of the 72 children in IFA placements, 46 (64%) children are placed in Herefordshire.

5.26 Based on successfully reducing the LAC population and achieving a 90% (in-house) /10% (IFA) split by 2024, it is expected that the number of IFA nights purchased will reduce from c.21,000 in 2018/19 to c.6,000 in 2023-24 (see 5.17 - Fostering Capacity Table).

5.27 Whilst it is positive that during 2017/18, 64% of children in IFA placements were within 20 miles of their home, additional work is required to reduce the number placed further away. This includes improving relationships with IFAs with carers in Herefordshire, by developing more effective communication through facilitating at least one provider event each year and introducing processes to ensure 4 weekly contact with each provider. This will ensure regular updates on current and planned vacancies are acquired, so these could be considered for Herefordshire young people, where applicable.

5.28 The average length of IFA placements has remained fairly consistent at 28 weeks. As of 31 March 2018, there were 64 children placed with independent foster carers (IFAs), of which 36 (56%) have been in placement for more than 12 months.

5.29 The graphs below shows that the age ranges of all new standard agency foster care placements made each year. Generally children aged 0-4 years are not placed with agency carers. Whilst the number of 11 to 15 year olds has remained fairly constant at 17; in 2017/18, there has been more fluctuation and a recent significant increase in the number 5 to 10 year olds being placed with IFAs, 85% being male. It is likely that the preference of in-house carers to take baby and solo placements has contributed to the more frequent use of IFAs for the 5-15 age group.

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5.30 Initial analysis of IFA placements shows a demand for services to support children who present with challenging needs and behaviours, including children at risk of sexual exploitation. Whilst HIPSS is meeting some of the highest needs, further development of the capacity and capability of general in-house foster carers would support children with the challenging behaviour needs, reducing the need for IFA, residential and distant placements.

Mainstream LAC Residential placements

Recent Demand

6.1 Spend on LAC residential placements has increased each year since 2015/16. The increase is predominantly a result of a number of children and young people having to step up to residential due to fostering placement breakdowns and a restricted in-house and IFA fostering market. Many regional local authorities are experiencing a lack of capacity in the IFA market, which is also contributing to their use of the residential sector.

6.2 During the period 1 April 2015 to 31 March 2018, 28 residential placements were made for 5518 bed nights at a cost of almost £2.4m, where the child could have been supported by appropriate fostering accommodation. The majority of these residential placements were made on an urgent or emergency basis (below), and after possible fostering options had been exhausted.

0

1

2

3

4

5

8 9 10 11 12 13 14 15 16 17 8 9 10 11 12 13 14 15 16 17 8 9 10 11 12 13 14 15 16 17

2015/16 2016/17 2017/18

Residential placements per during the year due to no foster care options - by gender and age at placement start date

female

male

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6.3 The impact of more children entering residential care because of insufficient fostering capacity was an additional cost pressure of £1.87m (below) over the three years. The pressure could have been further reduced had there been appropriate additional in-house fostering capacity.

Cost of children that could be fostered but were placed into residential care 2015-2018

6.4 In addition to the overall increase in number of young people in residential care, the average length of stay across all placements has increased each year since 2015/16; although it remains lower than 2014/15. It is understood that restricted fostering capacity, which has delayed some placement step-downs, is the main contributing factor to longer than desired periods of stay, rather than any practice or procedural drift.

6.5 The table below shows resulting destination of step downs from residential placements during the last two years:

2016/17

step down to HIPSS 3

step down to fostering 3

returned home 2

step-down to supported accommodation 1

2017/18

step down to HIPSS 2

step down to fostering 1

step-down to supported accommodation 3

6.6 The number of step downs to HIPSS is disappointing, and can be attributed to the pool of specialist carers not being at full capacity. However the service also supported young people and their carers, to prevent step up to residential. In addition to this, 5 HIPSS placements stepped down to non-specialist placements in 2016/17 and 3 in 2017/18.

6.7 Since 2014 almost 15,000 LAC residential bed nights have been purchased (see chart 6.16). With the exception of 2015/16, annually approx. 4k bed nights have been required. It is anticipated the reduction in bed nights required during 2015/16 was attributed to the work

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being undertaken to reduce the number of new residential placements. However progress has not been maintained, partly due to increased need for residential owing to unavailable foster care, and a reduction in number of HIPSS carers.

6.8 Most LAC residential placements continue to be made outside Herefordshire (above). In 2015/16, 7 out of 25 (28%) of LAC residential placements were in-county. However as of October 2018, only 1 out of 14 (7%) placements were in-county.

6.9 In 2015/16, 3 out of 16 (19%) of all new LAC residential placements were in-county (below). Only 20% of new placements were made in-county during 2016/17, whereas in 2017/18 24% were made in-county. However of the 18 new placements made in 2018/19 up to Oct 18, none have been in-county. This demonstrates further effort is required to source placements close to home.

6.10 There are 19 registered children’s homes in Herefordshire, of which 11 are registered to support emotional and/or behavioural difficulties, with capacity to provide 49 beds that are usually occupied by children placed from other areas. However as of September 2018, only 1 of 16 LAC residential placements were in Herefordshire. To address this, relationships with local providers will be improved, through facilitating a minimum of one provider event each year and introduce processes to ensure 4 weekly contact with each provider. This will ensure we acquire regularly updates on current and planned vacancies, so local places could be considered for our young people, where applicable. We will also work with our Local Authority Designated Officer (LADO) to explore re-instating children’s homes managers’ forums, which were previously well attended and valued by providers.

Future Demand

6.11 The recent demand for residential care has been more closely influenced by the capacity of the fostering sector than by changes in the LAC population. It is anticipated no more than 10

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LAC should normally require residential accommodation due to their assessed needs. This assumption does not include LAC with complex needs, covered by chapter 7.

6.12 In the short-medium term and whilst the local fostering capacity is developed, there will be a continued need for short-term residential placements for some children. It is anticipated these placements would be short-term placements of up to six-months while fostering options are identified and children are moved in a planned way. There is also potential to explore how short-term residential care may be utilised in other areas to provide support and space that enables children to avoid a family or fostering breakdown, and successfully return to the family/carers after a short time in residential care.

6.13 Of the 16 known children in a LAC residential placement in September 2018, it is anticipated 5 will require residential accommodation until they turn 18, and of the remaining 11 children it is expected that 8 will step down to alternative provision in 2018/19 and 2 in 2019/20. Whilst acknowledging it can take up to 12 months to recruit new carers, it is anticipated the need for short term LAC residential places will reduce during 2019/20. This will be supported by other work being undertaken by social care, including reducing the LAC population, which will also release general in-house foster care capacity. The average length of stay of those who do not require residential care to meet their needs, will also reduce as more step down options become available.

6.14 It is assumed that 7 new placements will be required in 2019/20, reducing to 3 by 2023/24. Based on this assumption it is anticipated there will be 9 residential placements required in 2024, and these will only be for those who require residential accommodation due to their assessed needs.

6.15 Based on the above assumptions, it is estimated that the number of LAC residential bed nights purchased will reduce from c5,700 in 2018/19 to c.3,600 in 2023/24 (below). This equates to an estimated cost avoidance of £1.8m in 2023/24, based on an average weekly fee of £3,600 for all residential placements purchased in 2017/18.

Complex needs population (CNF).

7.1 The CNF population in Herefordshire is supported by a tri-partite Section 75 funding

arrangement that includes resources provided by Education, Children’s Social Care and Health. The population is small but it incurs some of the highest placement costs for any child due to the complexity of their individual needs. There tends to be little turn-over within the CNF population, as once a child is admitted to the population, they very rarely step-down from it and often remain within it until transitioning to adulthood. Due to the wide-range and

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complexity of needs involved, it would not be possible to design a single placement model that could be commissioned for the CNF population.

Recent CNF Demand

7.2 The size of the CNF population has decreased since 2014, when there were 20 CNF cases to a cohort of 14 by January 2018. There are several potential reasons for the decrease including some young people ageing-out as well as a slower rate of entry arising from an improved short breaks offer, stable children with disabilities social care team, multiagency education, health and care planning, and the introduction of continuing care for children’s health provision.

7.3 A priority in the 2014-19 strategy was to enable more children with complex needs to be accommodated closer to home, which has resulted in 33% being placed in-county, as of March 2018, which is an improvement compared to 14% during 2014/15. Of those in placement on March 2018, 42% of CNF placements were within 20 miles of home. Of the 7 children placed more than 20 miles from home, 4 were within 60 miles and the furthest placement was under 160 miles.

7.4 Since 2014 a total of almost 23,000 CNF residential bed nights have been purchased. The trend has been a year on year reduction of c.500 bed nights being required from 6,500 in 2015/16, to a projected 4,000 in 2018/19.

7.5 There are three children’s homes in Herefordshire that can support children with complex needs. Between them they are registered to provide 56 places; of which one provider is registered for 30 places. As of September 2018, only three of these places were used for Herefordshire’s children. To maximise the opportunities to place locally, we will improve communication with providers, which will include acquiring 4 weekly updates regarding vacancies.

Future CNF Demand

7.6 Most children with complex needs, who require accommodation, will do so until the end of their education. In March 2018, the CNF population consisted of 13 residential and 1 non-residential support packages. The age ranges from 14 to 18 years, with 11 male and 3 female. Of these 92% (12 young people) have been in a CNF placement for more than 12 months. Planning is currently being undertaken to support 4 young people with their transfer to adult care during 2018/19, with a further 7 transferring by 2023.

7.7 Of the young people currently supported by the Children with Disability team (CWD), it is assumed that two children will enter the CNF population and require accommodation each year. It should be noted, however, that this assumption could be influenced by any potential future change to the tri-partite agreed CNF eligibility criteria.

7.8 Informed by the expected numbers of children exiting and entering the CNF population, it is estimated that c.4,000 bed nights will be required in 2018/19, reducing to c.3,700 bed nights by 2023/24 (below).

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16+ LAC Population

8.1 The 16+ population includes: Young people who are looked after by the local authority, including those that may

become homeless after age 16 or who may have been remanded into the care of the local authority by the Court

care leavers aged 18-25

8.2 Securing sufficient supported living provision for complex cases within Herefordshire continues to be a pressure. Supported living is for young people aged 16/17 and care leavers where support, with no element of care, is provided with the aim of achieving independent living. Provision includes supported lodgings provision (SLP) where a young person lives with a host family, in their home or an annex, and the family provide appropriate support. It can also involve professional supported accommodation delivered by organisations that offer accommodation, with staffed on-site support services, provided in commercial properties, including commercial tenancies for individual young people and homes of multiple occupation.

Recent 16+ demand

8.3 In recent years, 16+ placements have been commissioned by both the 16+ service and the council’s placements teams, with each service having different approaches to placement recording. More robust processes have been in place since 2016, which require all agency placements to be commissioned by the Placements team. It is recognised however that there are some weaknesses in the placements data provided by the 16+ team for 2015/16, which have made this assessment of recent demand and projection of future demand more challenging.

8.4 It continues to be difficult to identify the right placement for a small cohort of young people who present with higher end challenging needs. Whilst the numbers are relatively low, this has resulted in some young people having 2 or more placement moves a year. Further work is required to identify why placements were unable to meet need and if there is a relationship between placement stability and the type of initial referrals (e.g. planned, urgent or emergency). The overall number of young people who have had no or one placement move within the year has declined from 90% in 2014 to 74% in 2018.

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8.5 Since 2015, 57 young people aged 16+ have entered the looked after system with one third of being female. Annually 18% of new LAC are aged 16+. The main reasons they require accommodating are absent parenting and family dysfunction (below).

8.6 Herefordshire also supports unaccompanied asylum seeking children (UASC), some of whom have arrived through authorised routes and others independently. On arriving in Herefordshire, they become part of the council’s LAC population.

8.7 Based on data from April 2015 to September 2018, 8.5% of the LAC population (i.e. aged 16/17) requires supported living provision each year.

8.8 Since 2015, there has been a year on year increase in number of LAC supported living provision. This can be attributed to various factors, including

Improved recording insufficient in-house capacity, supported living provision being considered as a suitable option when a young

person aged 16+ foster care placement breaks down and where a UASC has requested a move to a more cosmopolitan location, and therefore

no longer accommodated in the local provision developed to support this cohort as part of the national transfer scheme.

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16+ provider market

8.9 Placements are made via in-house supported lodgings provision (SLP), or supported accommodation block contract and framework agreements. Spot purchase arrangements when no other options available. The majority (82%) of placements from April 2015 to September 2018 for 16/17 and care leavers were sourced with mainly out of county independent providers with in-house supported living hosts providing 18%.

8.10 Since 2015, the number of in-house SLP hosts available to support 16/17 year olds or care leavers had remained fairly static at around 20; with some hosts having dual registration as foster carers, so able to support either placement type. In March 2018, there were 32 registered in-house supported lodging beds (excluding those with dual registration), 18 (56%) of which were occupied either by a LAC aged 16/17 or a care leavers. Further investigation is required to identify the reasons for the apparently low occupancy rate.

8.11 The council has a block contract arrangement with a local housing association to provide semi-independent supported accommodation for young people who are looked after or care leavers with moderate needs. Since 2017, 50% (15 places) of the capacity over three foyer sites (Hereford, Leominster and Ross-on-Wye) has been reserved specifically for LAC and care leavers and subject to direct nomination by Children’s and Families Directorate. As of March 2018, the occupancy was 87%.

8.12 The housing association is also commissioned to deliver a “moving on” service consisting of 6 properties, predominately for 18+ care leavers to support them with developing skills required to take on a tenancy. Further needs analysis is on-going to inform how the two services will be re-procured when the current arrangement come to an end.

8.13 When either the in-house or commissioned supported accommodation services are unable to offer a placement for a young person, the Council can spot-purchase bed nights within the independent sector.

8.14 Since 2015 there has been an increase in the number of independent supported accommodation providers operating in Herefordshire, although this tends to fluctuate. In 2018/19 this has increased to 4. As of September 2018, five out ten 16+ LAC agency placements in Herefordshire, were with three spot-purchase providers.

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8.15 There continue to be challenges in providing suitable supported living placements for young people who present with more challenging needs, including those that are remanded to the care of the local authority by the court. These places have tended to be made out of county.

Future 16+ demand for looked after children

8.16 Based on data since 2015, on average 18% of children who enter the looked after system each year are aged 16 and 17, with 66% being male. Whilst some young people aged 16+ will continue to be supported by other social care teams, as of March 2018, the council’s 16+ service were supporting 56 looked after children and 117 care leavers were allocated personal advisors (PAs). It is anticipated a further 23 young people will transfer into the service from LAC team by March 2019. Based on the known LAC cohort (September 2018), it is also expected that a further 104 LAC will transfer to the 16+ service by 2024. Cases that are supported by the children with disabilities team will continue to be supported by that service post-16, rather than transfer to the 16+ service.

8.17 Of the LAC population as of March 2018, 118 will become turn 18 and become care leavers by 2024. The majority of looked after children aged 16+ will require some degree of care and therefore supported accommodation would not be suitable to meet their needs.

8.18 Based on data from 2015 to 2018, it is assumed for 8.5% of the LAC population may require some form of supported living arrangement. It is therefore projected 26 -28 young people aged 16/17 will require supported living provision in 2018/19 and this will reduce to 20 -23 by 2024. There could be some fluctuation in this projection depending on the number of additional UASCs that Herefordshire may support in future. The projected demand for supported living placements for care leavers is an area that requires additional analysis.

8.19 Based on most young people being aged 17 when placement starts, and the average lengths of stay being 231 nights (average from 2015 to Oct 2018), it is estimated between 6.0k to 6.5k LAC supported living bed nights will be required in 2018/19. This will reduce to between 4.5k and 5.5k in 2023/24. This is subject to achieving a reduction in the LAC population and individual’s assessed needs meeting the criteria for supported living i.e. no element of care required. Alternative registered provision will be required if supported lodgings is not suitable.

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8.20 Although Herefordshire has agreed to support up to 25 UASC’s (excluding care leavers), as part of the national transfer scheme, as of 30/09/18, Herefordshire has 5 UASC’s who are included in the council’s LAC population.

8.21 The above projections have been based current cohort as demand to take additional UASC is unclear.

8.22 Children and families are working in partnership with the Council’s Adult and communities directorate Housing department and contracted providers to commission a range of suitable 16+ accommodation. Early discussions have taken place with housing providers to begin developing service models and good practice examples of similar projects in different local authority areas have been highlighted. Further analysis is required to identify gaps in provision for 16+ looked after children and care leavers to inform commissioning activity.

Non-accommodation services (NAS) 9.1 Non-Accommodation Services support children, young people and families to work on their

emotional and behavioural difficulties by providing a safe and nurturing place where trained practitioners help bring about change or enhance well-being. Services include but are not limited to providing therapy, psychological assessments, parenting assessments, contact, family group conferencing, mediation and life story work. It is anticipated these services will be delivered in-house, however where there is insufficient capacity, inexperience to undertake specific assessment or an independent assessment is required, and services will need to be commissioned.

9.2 Since 2015, in the region of 320 individual assessments have been commissioned, with cost ranging from £25 to £5000, with an average of £750. This equates to a total spend of almost £250k. Initial investigations indicate social care team managers are commissioning these direct and lack of reporting has resulted in a breakdown of assessment type not being currently available. Further work is required to analysis need, which will inform a commissioning plan.

2015/16 2016/17 2017/18

Psychological Assessment 26,233 26,803 31,043

SEN Mediation 4,800 2,880 3,360

Assessments - other 38,586 21,726 12,272

Therapy 12,360 37,648 25,717

Total 81,979 89,057 72,392

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